Tuesday, February 25, 2014

Why Your Pediatrician is Your Best Choice

By Hansa Bhargava, MD
WebMD Medical Editor

If you’re a parent, it’s likely this has happened to you. You’ve had a hectic morning: getting ready for work, making breakfast and getting the kids ready for school. And then a wrench is thrown in: your child comes down with a sore throat and fever. If your child is sick, where do you take him?

Many parents would opt for what seems to be convenient solution: the retail clinic in the pharmacy down the street. Over the last decade there has been a large rise in retail based clinics. In a recent study, close to 25% of patients said they used them. Most thought about going to their pediatrician first but didn’t, mostly because the retail clinic seemed more convenient.

Recently, the American Academy of Pediatrics has taken issue with the use of retail clinics to treat children. The AAP’s statement specifically points out that retail based clinics are not appropriate for kids. Not only do these clinics often lack a pediatrician to provide the best care, there is also a lack of continuity of care for the child. Continuity of care means that the doctor at that clinic does not know your child and does not have his medical record. The lack of information could have significant medical consequences. What may seem like a small issue may be part of a bigger problem that could go unrecognized if the doctor does not know your child’s history.

From a medical standpoint, your doctor should know the most about your child and your family. This includes the previous illnesses he might have had, family history, allergies, medications previously taken and in certain cases, even social circumstances. All of this information can impact the diagnosis and the treatment. For example, if a child has had multiple strep throats, he may be a carrier and may need to be tested when he doesn’t have symptoms.

Seeing a pediatrician can also get you the best quality of care. Recently I saw a 3-year-old who was diagnosed with ‘bronchitis’ at a retail clinic and given an injection of steroids. It turned out that this child had a respiratory virus and did not need such a strong medication.

Good quality of care is especially important in cases of sports injuries, such as a fracture or concussions. Often, fractures in kids are difficult to see, so a wrist or elbow fracture may be missed if the provider at the clinic is not used to seeing children. And concussions definitely need to be followed, as they can affect a child’s ability to go back to sports and school.

Another benefit of a visit with your pediatrician? The chance to ask your doctor about other concerns that may have fallen off the radar, such as, ‘By the way, his grades have slipped’ Or, ‘He complains about not seeing the board at school’. These issues are important for the developing child.

As a working mom of two kids, I do understand the need for ‘quick care.’ And there are some cases, like when you are traveling, that you need to use retail clinics. But at all other times, seeing your pediatrician is the best choice. The good news is that more pediatric offices are adapting to the needs of busy parents. Most offices have open slots so you can get an appointment that day. Nurses are always available on the phone during the day to help you decide whether your child needs to come in. The majority of offices have weekend hours and a doctor on call in the evenings to help you at other times. And many doctors’ offices are trying to reduce wait times as they realize how this can impact the family.

So next time your child gets sick or injured, take your child to the doctor who knows him best and knows how to treat children best. Because, for all of us, getting the best care for our children is our most important priority.

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